Allergological examination in general practice and in the specialist field of allergology: A comparative study of the concordance between a group of general practitioners and the allergological specialised health care services to which they refer

Abstract

Objective - To study the concordance between specially trained general practitioners (GPs) and specialist doctors working as consultants to GPs, with regard to diagnosis of allergic illnesses, evaluation of indications for hyposensitisation, and referrals from GPs to specialists. Design - Thirty-four GPs and five specialists practising privately and eight allergologic outpatient clinics participated. The patients included had symptoms indicating allergologic examination. An identical diagnostic procedure was used by the GPs and by the specialists/outpatient clinics. Setting - General practices, specialist practices, outpatient clinics. Subjects - One-hundred and forty-eight patients. Main outcome measures - With regard to skin-prick test there was concordance between the GPs and the specialists in 82.5% of 1322 paired comparisons, in 74.0% with regard to anamnesis+skin-prick test, and in 66.5% with regard to the statement allergy. There was concordance with regard to indication for hyposensitisation in 88.3%, and for referral in 54.1%. There was symmetry concerning prick test and anamnesis+prick test, and asymmetry concerning the statement allergy, and indication for hyposensitisation and for referral. Conclusions - Specially trained GPs diagnosed specific allergy in concordance with specialists. There was asymmetry between GPs and specialists concerning the statement allergy, indication for hyposensitisation and for referral.